RT Journal Article
T1 Impact of an Antimicrobial Stewardship Program on the Incidence of Carbapenem Resistant Gram-Negative Bacilli: An Interrupted Time-Series Analysis
A1 López-Viñau, Teresa
A1 Peñalva, Germán
A1 García-Martínez, Lucrecia
A1 Castón, Juan José
A1 Muñoz-Rosa, Montserrat
A1 Cano, Ángela
A1 Recio, Manuel
A1 Cisneros, José Miguel
A1 Pérez-Nadales, Elena
A1 Rumbao Aguirre, José
A1 García-Martínez, Elena
A1 Salcedo, Inmaculada
A1 Del Prado, José Ramón
A1 de la Fuente, Carmen
A1 Martínez-Martínez, Luis
A1 Gracia-Ahufinger, Irene
A1 Torre-Cisneros, Julián
K1 Antimicrobial stewardship program
K1 Carbapenems
K1 Antimicrobial resistance
K1 Carbapenem resistant Enterobacteriaceae
K1 Carbapenemases
K1 Programas de optimización del uso de los antimicrobianos
K1 Carbapenémicos
K1 Farmacorresistencia microbiana
K1 Enterobacterias resistentes a carbapenémicos
K1 Klebsiella pneumoniae
AB Carbapenem-resistant Gram-negative bacilli (CR-GNB) are a critical public health threat, and carbapenem use contributes to their spread. Antimicrobial stewardship programs (ASPs) have proven successful in reducing antimicrobial use. However, evidence on the impact of carbapenem resistance remains unclear. We evaluated the impact of a multifaceted ASP on carbapenem use and incidence of CR-GNB in a high-endemic hospital. An interrupted time-series analysis was conducted one year before and two years after starting the ASP to assess carbapenem consumption, CR-GNB incidence, death rates of sentinel events, and other variables potentially related to CR-GNB incidence. An intense reduction in carbapenem consumption occurred after starting the intervention and was sustained two years later (relative effect -83.51%; 95% CI -87.23 to -79.79). The incidence density of CR-GNB decreased by -0.915 cases per 1000 occupied bed days (95% CI -1.743 to -0.087). This effect was especially marked in CR-Klebsiella pneumoniae and CR-Escherichia coli, reversing the pre-intervention upward trend and leading to a relative reduction of -91.15% (95% CI -105.53 to -76.76) and -89.93% (95% CI -107.03 to -72.83), respectively, two years after starting the program. Death rates did not change. This ASP contributed to decreasing CR-GNB incidence through a sustained reduction in antibiotic use without increasing mortality rates.
PB MDPI
YR 2021
FD 2021-05-16
LK http://hdl.handle.net/10668/4369
UL http://hdl.handle.net/10668/4369
LA en
NO López-Viñau T, Peñalva G, García-Martínez L, Castón JJ, Muñoz-Rosa M, Cano Á, et al. Impact of an Antimicrobial Stewardship Program on the Incidence of Carbapenem Resistant Gram-Negative Bacilli: An Interrupted Time-Series Analysis. Antibiotics. 2021 May 16;10(5):586
DS RISalud
RD Apr 7, 2025